Physician-assisted death and euthanasia in Canada: should it be legal or banned?

When Canadians saw the video from Donald Low pleading for physician-assisted death, it sparked a nationwide conversation on the issue. The public had grown used to seeing Mount Sinai Hospital’s microbiologist-in-chief at press conferences, poised and explaining how Toronto was battling the SARS outbreak.

But in this video, he is terminally ill with a brain tumour. Almost deaf and with one eye closed, he talks calmly about his own, imminent death. “What the end is going to look like, that’s what’s bothering me the most,” he says.

He asks for Canada to introduce assisted death options for terminally ill people, citing examples of other places worldwide that have done the same. “A lot of clinicians have opposition to dying with dignity. I wish they could live in my body for 24 hours, and I think they would change that opinion,” he says.

Low died eight days later. In his obituary, his widow, Maureen Taylor, wrote: “In tribute to Don, please advocate for the legalization of assisted dying in Canada.”

Less than a year later, that vision is closer to being realized. Quebec has passed a bill that will allow doctors to help some terminally ill patients die. And a case in front of the Supreme Court of Canada this fall could make physician-assisted death and euthanasia legal across Canada. But the debate surrounding the issue is far from over.

Related Faces of Health Care

“I’d put my hospital bed right here, with sunlight coming in, and I’d get to pass with dignity and in comfort, with help in my own home.”

Changing the laws in Canada

Quebec passed Bill 52, which allows for euthanasia, in early June of this year, by a 94-22 vote. It doesn’t come into effect until 2015, to give the government and doctors time to get the required policies and infrastructure in place. The bill allows Quebecers to have medical help dying, as long as they have “an incurable serious illness” and an advanced, irreversible decline in their abilities, and are at the end of their life. They must also be in constant, unbearable physical or psychological pain that cannot be helped. And they must be adults who are capable of consent.

Physicians will be responsible for making sure the patient meets these requirements, as well as getting a second opinion that confirms it from an independent doctor. They also have to make sure the request is made freely, inform patients of other treatments or therapies, and verify the patient’s wish at what the bill calls “reasonably spaced intervals.”

Doctors who don’t believe in euthanasia won’t be forced to perform it, but they will have to refer patients to a physician who is willing to. The system will be monitored and reported on by a provincial, arm’s length commission made up of doctors, health-care professionals, a jurist, an ethicist and a member of the public. It will advise the minister, report on end of life care every five years, and review every physician-assisted death to ensure doctors have complied with the rules. Institutions will also report on end of life care to their boards, including the number of requests for euthanasia and the number of times it was administered and refused.

The bill calls this end of life care. That positions it as part of health care, a provincial jurisdiction. But if it was challenged, the courts could see it as conflicting with the federal Criminal Code.

At the same time, those very laws may soon be struck down. This fall, the Supreme Court will reopen the Carter v Canada case. Kay Carter, who had spinal stenosis, and Gloria Taylor, who had ALS, filed a case with the B.C. Civil Liberties Association and a family physician in 2011. It contends that medically assisted death should be available to incurably ill, mentally competent adults who are not clinically depressed. It’s an issue the Supreme Court has been considering since Sue Rodriguez brought her case to the court in the early 1990s.

The BCCLA argues the current laws are “unconstitutional because they deny individuals the right to have control over choices that are fundamental to their physical, emotional and psychological dignity and restrict the liberty of physicians to deliver end of life care to incurably ill patients.”

The federal government counters that the laws protect people. “It is our government’s position that the Criminal Code provisions prohibiting physician-assisted death and euthanasia are in place to protect all persons, including those who are most vulnerable in our society,” federal Justice Minister Peter MacKay said in a statement.

Parliament could act quickly if the Supreme Court rules in favour of assisted death, thanks to MP Steven Fletcher’s two private members bills. One would change the Criminal Code so physicians can help patients die, and the other would establish a Canadian Commission on Physician-Assisted Death.

Worldwide, an increasing number of jurisdictions are legalizing physician-assisted death, where doctors prescribe a lethal dose of medication that patients take themselves, and euthanasia, where doctors end a patient’s life. The terms are controversial, with some preferring physician-assisted suicide and Quebec’s legislation using the broader “end-of-life care”; we’ve used euthanasia and physician-assisted death, following the Canadian Medical Association’s lead.

Quebec’s law allows only for euthanasia, but in Europe both physician-assisted death and euthanasia are legal in The Netherlands, Belgium and Luxembourg. Each country has its own regulations for who qualifies, but all require patients to have a disease that won’t improve, be suffering unbearably and offer voluntary consent. Switzerland allows assisted death for people who aren’t residents, making it attractive to some Canadians who have flown there to die.

Closer to home, some U.S. states have also legalized physician-assisted death. Oregon, Washington and Vermont require people are adult residents who are competent and expected to die within six months. Patients must make two requests, 15 days apart, and their physicians can request a psychiatrist consult if they feel it’s necessary. A judge also recently ruled that people in New Mexico have a right to “aid in dying.”

The public-physician divide

Public support for some form of assisted death is high: a 2012 Angus Reid Poll found 80% of Canadian respondents backed it under certain conditions. Another in 2013 found 86% of Quebec respondents wanted it, following a 2010 survey that found the highest levels of support in Quebec at 78% and the lowest in Alberta, at 48%.

But those numbers are lower among doctors. This may be because they’re hesitant to approve of something without knowing the details. “Doctors don’t know what the rules of the game would be,” says Udo Schüklenk, chair of The Royal Society of Canada’s Expert Panel in End-of-Life Decision Making. “It’s understandable that they would be reluctant.”

Physicians may also be worried that they may have to take part – though in all jurisdictions where assisted death is legal, there is the right to conscientious objection. And there are logistical issues that would follow. “Our group has started to have these kinds of discussions already in anticipation that the legislation might change,” says Sandy Buchman, a home-based palliative care physician who works with the Temmy Latner Centre for Palliative Care at Mount Sinai in Toronto.

The Quebec Medical Association approved of Bill 52. But a 2014 position statement from the Canadian Medical Association on euthanasia and physician-assisted death came out against both options. Before either are considered, the association asks for an expansion of palliative care services, maintaining and strengthening suicide-prevention programs, and a study of medical decision making near end of life.

The ethical issues

Proponents of euthanasia and physician-assisted death often focus on autonomy. “When you consider who is the best person, place or thing to make an informed decision about how to end your life, I don’t think it’s the state’s decision, I don’t think it’s a religious body’s decision. I think it’s an individual decision,” says Wanda Morris, CEO of Dying with Dignity.

That’s connected to withholding and withdrawing treatment. Some argue that “we allow people to refuse treatment when the known consequence is death, and there isn’t a defensible basis for drawing a distinction between withholding and withdrawal on the one hand, and assisted suicide and euthanasia on the other,” says Jocelyn Downie, law professor at Dalhousie University. She sees assisted dying as a spectrum, with withholding and withdrawal on one end, and euthanasia at the other.

“I think [physician-assisted death and euthanasia] is an important option that should be available to all Canadians,” says James Downar, critical care and palliative care staff physician at the Toronto General Hospital. “I think it’s important to recognize that there are types of suffering that we do not have the ability to treat. There are dying patients who have a very low quality of life from their perspective, and sometimes only death would end their suffering.”

On the other side, a common concern – and one that the CMA makes – is the slippery slope argument. It’s the concern that vulnerable people may feel pressured into deciding to end their lives. But evidence from other jurisdictions provides a counterpoint. “In none of those jurisdictions [that have decriminalized physician-assisted death] would you find any threat to people who are vulnerable,” says Schüklenk, pointing out that in European countries, the average person who uses these programs is male, with middle to upper class income and education. “By any stretch of the imagination, this is not what we would understand commonly as vulnerable people,” he says. In Switzerland, people who choose assisted death are more likely to have more education, live in urban areas, and have a higher socioeconomic status. A study of those who participated in the Death with Dignity program at the Seattle Cancer Care Alliance found the average participant was white, male and well educated.

Others think physician-assisted death demeans the disabled. The most commonly requested reason for it is not pain, but disability, which is “really concerning,” says Margaret Cottle, vice-president of the Euthanasia Prevention Coalition. “That is saying disability equals indignity, and what does that say to the rest of our citizens who are living with disability?”

The most common reasons people in the Seattle Death with Dignity program gave for wanting to die was “loss of autonomy (97%), inability to engage in enjoyable activities (89%), and loss of dignity (75%).” Similarly, of the 72 people who received a prescription for lethal medication in Washington State in 2010, 90% were worried about losing their autonomy and 64% about losing their dignity.

Jessica Simon, head of the division of palliative care medicine at the University of Calgary, is also concerned about those reasons. “I worry that people fear dependency,” she says. “The act of dying by definition is a time when we become dependent on others, and I think it’s much more important that we develop ways to support people through that dependency … than seeking to quickly dispose of that time.”

The impact on palliative care
Palliative care doctors, including Bernard Lapointe, Manuel Borod and Balfour Mount, have come out against Quebec’s legislation, saying most palliative care doctors are against it and that it blurs the lines between palliative care and euthanasia.

“I think people don’t really have a good grasp on what the difference is between palliative care, palliative sedation, physician assisted death and euthanasia,” says Dori Seccareccia, a palliative care doctor at Sunnybrook. “I think people are voting for, help me when I’m suffering, I want to make sure there are as many options as possible when I’m suffering. And if palliative care isn’t an option, we worry that people are going to vote for euthanasia or physician-assisted death, because they think that’s all there is to help them.”

There’s also the fear that euthanasia and physician-assisted death will distract from the need for more palliative care in Canada. To counter this, many jurisdictions have addressed end of life care as a whole when legalizing physician-assisted death. In Quebec, the new legislation includes the right to palliative care. That would be difficult to execute if legalization across Canada comes from the Supreme Court, since palliative care is a provincial jurisdiction.

Many palliative care doctors believe continuous palliative sedation therapy, where a patient is sedated for the last few days or weeks of life, is an option that removes the fear and pain of dying for most people. Buchman remembers a patient who had ALS and requested he hasten death after she was “locked in” – unable to communicate or move in any way, while remaining aware. They decided to use continuous palliative sedation therapy when she was at the end of her life, and when she requested it by blinking twice. Buchman feels that she had a comfortable, peaceful death. But “if she would have had the option to hasten death, she probably would have taken it,” he says.

And some worry physician-assisted death would erode trust in palliative care doctors. “Introducing the idea that a physician can care for you when you’re dying but could also actually hasten your death, you’re changing the fundamental relationship between physicians and patients,” says the University of Calgary’s Simon.

Dr. Low’s wife, Maureen Taylor, says he had excellent palliative care, but it wasn’t enough. He ended his life sedated at home. “I slept next to my husband for eight days where he was basically in a coma…. He couldn’t feel pain, he couldn’t feel hunger, but he also couldn’t talk to his family. He had to be diapered, which was something he never wanted. It was like a living corpse in your house,” she says, adding that watching him gasp for breath under sedation was awful for the family. “I’d turn it around and ask, who benefited from Don having to live the last two weeks of his life like that?”

Buchman thinks Canadians need to have a more thorough discussion about palliative care and death before changing the laws around physician-assisted death.

“I don’t think we’ve had those kind of discussions yet,” he says. “And I think the time is right.”

Enter the debate: reply to an existing comment

90 comments

Amy HasbrouckAugust 7th, 2014 at 2:16 pm

Once again the voice of people with disabilities, the population most directly affected by medical killing, is left out of what is supposed to be a balanced, neutral article. For 20 years, the Council of Canadians with Disabilities has worked against the discriminatory inherent in euthanasia and assisted suicide. The first eligibility criterion listed in the laws allowing these practices is that the person have a serious, incurable illness that limits their functioning; in other words, a disability. The requirement of suffering, not limited to physical pain and which can include unresolved grief over becoming disabled, is secondary, and assumed to arise from the first criterion. The requirement that the person be dying is often absent (as in the Fletcher bills) or given lip service (Québec’s law doesn’t even define the term “end of life”).

%featured%The central conundrum is that medical killing undermines the societal goal of preventing suicides. It says that some people — young, healthy, misguided — should be prevented from killing themselves, while others — old, sick, disabled — should be helped to commit suicide. It assumes that the mere fact of having a disability causes suffering, and that it is a rational choice of anyone with a disability to want to die.%featured%

In addition, where more than 90% of suicide attempts fail, such failures are usually considered to be a cry for help. However providing suicide assistance only to people with disabilities will virtually ensure death in those cases. What about the right to cry for help?

The circumstances that drive many people to want to die have less to do with the physical condition, and more to do with the realities of disability discrimination. Poverty, lack of home-based personal assistance and home modifications, inaccessible public transportation, public places, voting and employment, and inadequate health care all result in a lower quality of life. Add to that elevated rates of abuse and negative attitudes toward people with disabilities.

The statistics cited about the “safety” of legalizing assisted suicide and voluntary euthanasia do not take into account the “off-the-books” euthanasia that continues unabated in these jurisdictions. As well, many people with disabilities can recount incidents of being badgered to sign “do not resuscitate” orders on entering the hospital, even for routine procedures, or fighting to obtain ordinary but life-sustaining care, such as antibiotics or respiratory support.

Disability rights advocates often say that disability is the only minority group that anyone can join at any time. The mania for assisted suicide is symptomatic of the “better dead than disabled” belief which is widespread in our society. Of course no one wants to face the kind of exclusion and discrimination those of us with disabilities deal with on a daily basis. So we can either change the way we treat people with disabilities or we could allow the government to sort suicidal people into “disabled” and “non-disabled” categories for differential treatment.

In fact, according to a 2013 YouGov poll of 1036 individuals with disabilities in the UK – the first of its kind – 79% of those polled wanted the option of assisted dying at the end of life in the event of terminal illness.

The case for choice – including for individuals with a disability – was very eloquently made by Joe Arvay, chief counsel for the case for the right to die with dignity (now scheduled to be heard at the Supreme Court of Canada in mid-October). As a top constitutional lawyer, Joe’s arguments are always clear and articulate. But the fact that he delivered this one from his wheelchair (he was paralyzed in a motor vehicle accident while at university in 1969) made it even more compelling.

Speak for yourself, but don’t presume to speak for the majority of individuals with disabilities who do want the choice to avoid needless, unnecessary and unwanted suffering at end of life.

I believe that people with disabilities are not the focus here. I am assuming that the group of people who believe that the disabled should be put down because of their disabilities.

The people who are the focus of this discussion are the terminally ill. And for these people, as they get closer and closer to the end are tired of living in constant pain, and yes, being entirely dependent on others. Palliative care is a wonderful thing for those who can receive it, it provides medical and emotional support. But what happens when that is not enough? When making life ‘as comfortable as possible’ (who makes that decision and who determines if it is?) is not enough? There is no one so enlightened that can know any one elses pain.

My Mother died a couple of years ago, a victim of ALS, an incredibly painful and quickly progressing disease which destroys the nerves throughout the body. I discussed with her her fears, and they were not of dying (we should not fear death), but of the process of dying. Her decision to not take control of her death (I would have assisted her in some way had she let me) was that she could not make it o.k with her God. This is another argument, though to me, it should not be. Terminal diseases were not caused by God, they were created by us, through our use of and manufacturing of various products etc. We are meant to suffer in each life we have, I understand that, but to believe in whatever God you want, and to think that that is how he wants our lives to end, is ridiculous. Why?

I know that the disabled are often discriminated against and I detest that they are but, as I stated earlier, I don’t believe that they are part of the issue. There are those who are disabled to the extent that they cannot do anything for themselves and can communicate or show without a doubt that they are in incredible pain, constantly.

As long as there are strict assessments and procedures (which is the hardest part) then doctor assisted death is not a ‘murder’ but a merciful act. I have incredible respect for your views on the disabled but should you have the chance to really and openly speak with someone who is near the end of a terminal disease, ask them about how they feel. How they truly feel their pain and suffering. Not all want to take control of their death, of course, and they should be respected, of course, but for those who do, why should we not care? Medication, if it works, can often dull the mind as well as the pain but why would you want to live like that? And support and palliative care can only do so much. It is often for the remaining loved ones that many endure the pain.

@ Amy Hasbrouck. You state, “The central conundrum is that medical killing undermines the societal goal of preventing suicides. It says that some people — young, healthy, misguided — should be prevented from killing themselves, while others — old, sick, disabled — should be helped to commit suicide. It assumes that the mere fact of having a disability causes suffering, and that it is a rational choice of anyone with a disability to want to die.”

I’d like to make 3 points in response:
1) Suicide prevention consists of providing interventions/coping mechanisms targeted to work against suicidal ideation.
2) Medically-assisted death has nothing to do with “suicide.” Suicide is a misnomer for describing the life-ending choice of a seriously and incurably ill person. Those who choose assisted death do not want to die; they want to end their suffering. When palliative care and other interventions do not work to end their suffering, medically-assisted death is an intervention that can overcome those limitations.
3) It’s not the fact of debilitation (as distinct from disability) that makes medically-assisted death a rational choice. It is futility of suffering.

The provision of excellent end-of-life care is the real solution. People need to know they are valued even if they have a disability, are chronically-ill or suffer from a terminal illness. If medical professionals become death-dealers through legalization, then the patient can never be sure that they will be cared for, rather than have death imposed upon them!

As President of Hospice Patients Alliance, I hear from people all over the world including Canada, the USA and other nations. Families are already reporting widespread practices that involve hastening the death of the vulnerable in healthcare settings. Why would we give even more power to end life when caring for the patient with top-notch hospice and palliative care is the answer?

Although those who advocate for legalization of euthanasia and/or assisted-suicide often cite pain as a justification for legalization, most people who are pushing these changes do not have pain but have depression or other psychiatric problems. Should we be hastening the death of those who need good mental health support, counseling and love? I don’t think so.

In addition, in places where legalization has occurred, it is an open “secret” that a utilitarian view of the patient’s life plays a role. In other words, the retired or disabled or ill are seen as “non-productive” and therefore, not worthy of receiving the same healthcare others get, usually under 65 years of age. What kind of society are we to be if we limit treatments for the elderly or disabled and then end their lives?

It should be realized that in many, many cases, the elderly patient may have some dementia and OTHERS will be making the decision for the patient. In other words, the request for assisted-suicide is made by others and the administration of the medications to end life is made by others. Then, assisted-suicide is actually direct euthanasia: the medical killing of someone who actually never requested it himself or herself!

When ending the lives of the patient becomes a routine option in medical settings, then no citizen (patient or not) will be safe, because anybody can be declared a patient, be declared incompetent, and someone ELSE can make the decision and end their life. In effect, the vulnerable can be manipulated through the orders of a physician, an attorney, a court or any combination of these and have their life ended against their will. This is exactly what we are hearing about already from people all around the world: the involuntary imposed death of the vulnerable, often through stealth (undeclared, unrecorded euthanasia).

With respect, Mr. Panzer, it doesn’t appear that you have personal experience with the prolonged, painful death of a loved one. I can only hope that attitudes like yours are not shared by my caregivers should I ever become terminally ill.

As my doctor said “no one should be killed to make anyone’s life easier”. And that sums it up. Instead of trying to do the very best we can for those who need us the most, we don’t want to if we believe euthanasia or assisted suicide is the answer. It is easier to kill them. If doctors are up to date on palliative care, then the patient can be kept comfortable. It is not about our convenience, it is about them. It is not about what we must see at end of life and accept as death approaching, it is about them.
We have all gone through a depression sometime in our lives. Thank goodness it did not lead to my suicide but made me a stronger person for working through the problems. When I was a child, I thought as a child, but now I am an adult and must think as an adult. That does not mean life is easy. Let’s grow up. We must believe all life is precious if we want our society to have an ethical and moral basis. It is not up to us to decide on who is “good enough” to stay and who is “not good enough” so must die.

It has nothing to do with “good enough” or “not good enough”. It has to do with (and ONLY with) the patient’s wishes! Palliative care is NOT perfect, we only wish it was! What right does anyone else have to insist that someone ‘stay and suffer’?

But here’s what I hope even more: Palliative Care – its approach and philosophy – becomes the focus and gets the attention it deserves. %featured%Nothing to do with assisted death/dying/suicide, the Palliative approach and philosophy is everything to do with comfort – emotional, spiritual, physical and social – right up until life’s end.

Would that more energy was spent digging into mis-perceptions and confusion – across all healthcare sectors – as well as we the public. Far from being the perceived ‘death sentence’ studies show Palliative Care can extend a life – and a life that has quality.

Palliative Care – with its focus on symptom management and comfort – may not be seen as debate material. You’d be wrong. As with much of medicine, in palliative care there may not be a guaranteed answer, and there may be more than one solution. But each solution asks not how successful is the procedure from a medical point of view, but how well are we taking care of the patients/families physical and emotional needs.

Palliative a model of Person Centered Care, and should be the Model for Person Centered Care. Imagine: a team of healthcare professionals collaborating on how to meet your needs.

I wager, if you had another poll: on a scale of 10 (with 10 being extremely important) the results’d be a predictable 9 or 10:

How important is it to be as comfortable as possible right up to the end of your life:

[Comfort includes: being at peace, not physically suffering, not mentally suffering, not emotionally suffering.]

Oh, and for those who worry that the sick and elderly will become victims: Euthanasia is regularly carried out today– immoral and illegal tho it may be. Elder abuse. Shortens life and to hasten death. No quality of life and nothing dignified about it at all. What’s in place to protect this vulnerable population? Perhaps the topic of another debate;-)

Thanks Kathy, I think Quebec’s comprehensive approach is ideal. Bill 52: An Act Respecting End of Life Care, slated to come into effect in 2015, makes palliative care a right for all Quebecers, promotes advance care planning and provides the option of medical aid in dying for those who are suffering unbearable and want to choose an assisted death.

At Dying With Dignity we also invest time and effort educating people about their rights as healthcare patients. Many horrific deaths could have been avoided if only people were truly informed in their decision making or were aware of their rights to stop or refuse treatment (either themselves or through a substitute decision maker).

Doctors really do die differently from the rest of us – because they are informed about the actual consequences of different treatments and know their rights. We want to bridge that gap.

I am a nurse, people should have comfort knowing that their pain will be gone and love ones will not have to watch while their love one is in constant misery no one should control the wishes of a terminal ill person
People sit behind desks and make decisions about another persons body,it is high time they butt out.I hope an pray God gives me the strength to do something before I am an incapable to do so

%featured%As a 20 year Volunteer in a fairly large Palliative Care Unit in Toronto, I have seen more than my share of ‘death/dying’ and more than a few, that were long and drawn out, where comfort and pain control could not be achieved.%featured% The patients were in intractable pain and the suffering for all who were involved (patient, family, nursing staff, physicians etc) was unimaginable. It’s not an anomaly, it is and continues to be a fairly regular occurrence. We as Canadians, need to change the laws to allow both Euthanasia and Physician-assisted death . I agree wholeheartedly that better and more available Palliative Care should be instituted but, make no mistake, it does not and cannot solve everything for everybody.

Amen…… makes no sense to me to have someone put into a medical coma to try and deal with the pain, but they still need their diaper changed and for someone with bone cancer even in that coma state the pain is awful. And for what – to live and extra week? Like you said Pearl – We need both Euthanasia and Physician assisted death as well as more Palliative and Hospice care. I hope it is there if I need it so my son does not have to witness what we did with my dad.

The last person I watched suffer a slow, painful and heart-wrenching death was my uncle who finally refused to eat or drink and all “else”. It saddens me that DWD is withheld from those who want it and need it.

I don’t understand why our professionals think it’s more humane to make a person suffer right to the bitter end. We don’t want to let our pets suffer when it’s hopeless, why are we making people suffer needlessly, when they can get their personal effects in order and then be gently put to sleep, knowing it’ll be ok when they’re gone. We resist death to the point of causing more suffering for the ill patient, not because it’s not right, but because we can’t let go. If I ever have a terminal illness, I hope assisted death is legal by then, because whether it is or not, I’m going to find a way to end my suffering

‘Understanding Will Never Bring You Peace. That’s why I have instructed you to Trust in Me, not in your understanding. Human beings have a voracious appetite for trying to figure things out, in order to gain a sense of mastery over their lives. But the world presents you with an endless series of problems. As soon as you master one set, another pops up to challenge you. The relief you had anticipated is short-lived. Soon your mind is gearing up again: searching for understanding(mastery), instead of seeking Me(Your Master).’

If someone is experiencing a terminal illness or disease where death is imminent. Make them comfortable( pain medications, not forced to eat, No CPR), and if all goes right…have family around and love them to their next journey in the life after..
Do people understand that Denial is the worst place they can be when it comes to a loved ones dying process. Denial…if people can get past Denial, there is much hope and comfort for those that are dying.

When a human being can create another human being or bring one back from death after they have killed the person, then I will consider assisted killing. How do we know how the person feels after they cross from life to death? Maybe, they wish they could change their mind.
This is playing God, who alone, holds our lives in His hands.

I do not believe in your god either, I mean, who, in their right mind would? After being diagnosed with terminal cancer at age 47?…. I don’t think so. Your god or whatever is meant to take the credit for the Cure (if there was one) but not for allowing this disease to infect me LOL! Please do not preach to terminally ill people about their choice (often the only one we are allowed) on their OWN end of life. I really resent having an imaginary dogma thrown at me by so many.

I feel that I should have the right to die with dignity, in the way that I feel is dignified. I feel that we should all have that right and my way may not look the same as an other but I should still have that right. I do not feel religion should have any bearing on this issue. If your religion doesn’t agree then don’t do it. But the law should protect all views. I don’t want to die suffering if their is no need to suffer.

People need to understand that even with palliative sedation the dying person is starving and dehydrated …often not eating or drinking for sometimes up to 2 weeks …how does that feel? And what is the point? Even though sedated they can still struggle to breath gasping and gurgling….I nursed for over 30 years and watched so many patients struggle to die ….death is inevitable and should not be feared …if a terminal patient can go sooner with less struggle I really don’t see that as being a problem but see it as a gift …

There’s so much grey in this controversial topic. “and they must be adults capable of consent”. Does this take all rights away from families watching their child or someone who is mentally incapacitated and unable to give consent; and leave them to watch a long painful or comatose death?
Depression follows suit with terminal illness and disabilities; physical and psychological pain. Personally I think disabled people should also have the right to end their lives.
On the objective side why extend the financial burden on our healthcare system keeping someone in a state of sedation for who knows how long before death finally occurs or months or years of medical treatment postponing the inevitable. People should have the right to die quickly and peacefully as our pets do at the veterinarians!

Having had to watch end of life in family members and, of course, knowing them and their wishes for everything in life, there are common threads that I have noticed as a layperson. It didn’t matter what their lot in life was, able or disabled, they wanted to end life on their own terms.

It has been the people surrounding them, family, doctors/medical professionals, “humane” based groups, religious groups, political groups etc. ad nauseum, that are having a problem with the person’s end of life.

Of course all of these groups and individuals care. No argument there, no reasons blah blah. They are undoubtedly all good people.

%featured%But, just as your lifetime is made up of personal choices all along its pathway, so should the end of life be a choice.%featured% And no, I am not talking about suicide or any other segway. Semantics begone.

Each individual should indeed have the right to make decisions about themselves. Unbearable pain, not relieved in my dying father’s case, had to be endured because the doctor said he could become addicted. There are enumerable stories, each with its different reason/s.

I do not want my family to see me gasping for air, being in a vegetative state unable to communicate, suffering indignities to my body, and in pain that is indescribable, nor do I wish to be feeling all of this, knowing the pain my family is in as well. It’s my decision to make, no one else’s. That is my right to freedom.

I imagine most of the self described moral police telling total strangers how they should act, what they should believe in (god) and how much they should suffer don’t even realize how ridiculous their notions are.

If the decision to die should be left ‘in god’s hands’, and that’s your belief, then fine. Never accept any medical treatment throughout life then. Your god, or deity of choice, should also be the one who decides your full destiny. This would save billions in tax payer dollars as well.
Those of us who choose to manage our own destiny without a dirty to decide for us, should be allowed to.

I also must respectfully dispute the fact that these ‘groups (religious, political)’ and individuals who are ‘choosing life’ (pain and suffering really) actually care for the individual who’s suffering. Many times the family insists on keeping the patient ‘alive’ to keep the cheques rolling in. Don’t believe me? Talk to some nurses…

The religious don’t care about that one person (after all, that dying suffering person could be a sinner in one form or another) either. They just need to exert the power and control and maintain their donation numbers.

The political parties only care about the popularity of the idea and whether it gets them elected.

So…again…tell me why anyone would be against allowing a stranger in a town 2000 miles away, to choose his/her own destiny?

The selfish nature of these so-called religious do-gooders and the audacity to think they should speak for another amazes me…

If a sick, terminal person wants to exit this life, they should be able to get a pill or drink to do so peacefully. Period.

i agree, no one should tell you what to do, whether they believe in God or not. That sets my teeth on edge too. The remark, however, that “[t]he religious don’t care about that one person (after all, that dying suffering person could be a sinner in one form or another) either. They just need to exert the power and control and maintain their donation numbers” is overgeneralization and hyperbole: not every religious organization (or person) acts out of those motives. It is unfair to paint “the religious” with the same brush. For instance, it is true that some humans are just plain sleazy. Religious organizations are made up (hopefully!) of human beings (some of which are sleazy, unfortunately). Therefore, some religious organizations (or persons) do act out of sleazy motives; they shouldn’t act like this, but they do. This is a sad trait engendered in humanity, not religion. I am sorry for the experiences you have had that have left this bitter impression on you.

Is there such a thing as death with dignety, perhaps in countries that allow persons to choose their own death,
While I haven’t seen a lot of people dying, maybe 5 that I truly recal, there was nothing dignified about any of them, they were all but one, like a very slow bloched execution.
Death is ineviable , and you can say all you want about palliative care, but it is not going to change the fact that a person is dying. For who’s benifit is a person put in an induced coma to extend their life?

Having watched both my parents, grandparents, in-laws and some Aunts and Uncles too, dying slow painful deaths of cancer (different kinds all pretty horrible, I am fully in favour of a person right to die. My father when he was dying asked me if I’d take him to the vet I had a dog put to sleep about the same time my father was dying. The dog’s death was quick and painless my mother’s and my father’s deaths were both very long and painful. My Mom had bowel cancer and had to be starved to death because they could not operate and there was a blockage she was 84 they starved her gave her lots of morphine and it took about 10 days to die. My Dad took about 6 months slower and just as painful he had lung cancer. The dog was blessed. When in the name of all that is decent are we going to start treating people as well as we do loved pets? I for one would be quite happy to have this available to me and in the long run it also may save a little money in end of life treatments, hospital stays and hospice time for our health care system. Please allow this choice for people who want it. If you have religious viewpoints that prevent you from wanting this fine but please allow me my choice!!!! This choice could be limited to adults who are terminal.

I agree that it is time. Some say that we are asking to be able to ‘kill’ our loved ones because of some ‘inconvenience’. I am sure these people exist but most of us, think of the loved one who is dying. For me, it would have been better FOR me to have my Mother around longer but, for HER, death was undoubtedly a blessing. If she wanted it, I would gladly and wholeheartedly helped her find a Doctor who would help her die when she wanted. Suffering from ALS, by the end, my Mother was in horrendous pain. Who would want that for their loved ones. I think that the argument of killing those who are ‘inconvenient’ is not valid for the greater populations around the world. The argument for compassion for those who decide (clearly and without duress) that they can no longer bear the pain, no matter how ‘comfortable’ they are made.

It seems like most of the people objecting to it are more concerned about their own comfort levels than those of the dying person. NO ONE else can know how important it is to that person to control their own destiny, dignity and function, and NO ONE else has the right to make those decisions for them! It reminds me of the rules that no one could exceed the pain medication dosage or timing “because they might become addicted”!! HELLO? They’re DYING …

I was 24 years old when my Mom was diagnosed with Terminal Cancer. I moved back hope with my young son – 6 months old at my Dad’s request. My Mom wanted to die at home. I had to learn “palliative care”; was responsible for changing her dressings three times a day; injecting her with Morphine every 4 hours [praying I did not strike a bone]; bath her; encourage her to eat/drink and so on … while taking care of my Dad and my young son and maintaining the house. There was no family that came to help out. I watched my Mom slowly die … watched her suffer a horrible death – fade away from 130 pounds to well below 60 pounds. At the same time, trying to prepare myself for her death … there was no support provided. Eventually she went into a coma, after the cancer had ate her bones; her liver; and brain. She moaned for three days constant. These memories will never leave me. When she passed, I was interrogated by the police for hours … I watched the Fire Department try to resuscitate her … NEVER would I wish this death on another human being. It is imperative that the laws in Canada be changed.

Let people die with dignity. If you believe the soul/spirit goes to a better place when you die, how can you possibly deny anyone the right to go??
Secondly — if you let your dog/cat suffer needless pain you can be charged by law — but you must let your grandparent, parent etc. suffer the agony of the damned to the bitter end — where is the compassion? the logic? and further, who or what gives anyone the right to tell someone else what to do with their bodies?

They already are killing our loved one nor through Antipsychotics and Morphine. Giving them a green light will be nothing less than cleansing ourselves from what we may feel the People who are a burden to the new society who has grown very selfish, greedy, and self absorbed. STOP the killing and don’t give the Government or Doctors the power to shut the switch off on life! Only God can do that, not you, I or anyone, and for no reasons at all!

I watched my brother (58yrs. old) last week, dying slowly, in excruciating pain from bone cancer. In order to die quicker, he chose to stop his dialysis. He then lived for another week. No one deserves to die in this manner.

Our mother is an ALZHEIMER patient. She has gone from a beautiful soul to a lost soul. We find ourselves trying to remember all the wonderful memories of this beautiful woman to be overpowered by a disease that makes it difficult to remember anything else. What is the right choice I don’t know but to see a human being lose the ability to live life to me seems wrong. Our mother would be mortified if she knew what was being done for her. A woman with so much pride and dignity has lost it all. She exists here in body only that once beautiful mind has gone.We need to be the voice for these people because if I believe anything it is that they are begging for help!!

I’m rather surprised a physician is telling us what “we think”. How incredibly arrogant! Adults DO UNDERSTAND the difference between suicide, euthanasia and options to die a slow death in any sort of facility, lengthening the pain to ourselves, emotional stress to ourselves and families/loved ones etc. Never mind the ridiculous costs associated to all of the above to delay an inevitable outcome.
Life isn’t necessary to be prolonged. Existence is what is being described by prolonging an unchangeable outcome…and that should be for US to decide.

ITS MY BUSINESS, MY CHOICE: All these discussions to control other people, who do not want to live further. Be it due to mental illness, or physical illness. Processes put in place to make it cumbersome and lots of red tape. It is about control, who control your body? Government? Why? Or you. This discussion I find sickening when I see loops put in place, not to protect society or to make passing less painful, but to dictate terms to people about their end of life situations. And this perhaps is the most disgusting thing of all, it is a travesty. This is a matter for the individual to decide, not government, not a church, not charities making money from the unsuspecting, and not anyone else inclusive of family .. it is an individual choice. Respect it. For those against assisted dying, you do not have to look at or take this option, it is your choice. Respect mine. As for the Council For People With Disabilities, I grow tired of your fear mongering. Those with disabilities can choose assisted passing, or not, it is their choice., don’t force you grant and donation rich Not For Profit Charitable Organisation’s views on me, or others, keep making the money from selfish positions and keep getting that charitable money and large paycheck. For me and many others, it is not about exploiting a situation for profit, we are not like your charity, we have no financial gain in our choices what so ever, but when life gets too tough, we want to accept the closure of “our” circle of life, and leave this life peacefully. Stay out of my business, it is not yours.

I believe that if i am terminally ill and suffering why drag it out,I would not let my beloved pets suffer at all so why should i?I have seen friends gone through hell and they all died and most were very painful
and not a comfortable death at all.I believe people have the right to a Death with dignity and not suffer with constant pain until the end finally relieves them from it.Drugs for pain can help but most people are so out of it they are in never never land anyway.I hope that the laws are changed so we can decide when we cannot handle the pain and suffering anymore,and take the heavy stress off our loved ones.

We call this a society, we call it civilization, we call it the age of science, technology and information. How dare anyone say these words without the slightest inclination of hypocrisy in their heart. If society and civilization can recognize mercy and the deliverance from suffering and whole heartedly afford it to our beloved pets. Then how is it possible to forcibly imprison your loved ones to a slow, agonizing intolerable suffering? Sadly the family and friends of the terminally ill are also forcibly made to suffer by bearing helpless witness to their loved ones agonizing decent into decacation. Could you possibly comprehend what it is like to try do anything and everything in your capacity to make it better and still know in your heart that you are failing? That despite your best efforts you can’t make it go away? That is the emotional trauma that every grandfather, grandmother, father, mother, brother, sister, aunt, uncle, cousin, husband, wife, partner, lover, friends and more importantly your children will be made to suffer. It was one of the most desolate chapters of my life. Assistance provides a dignified and humane peace to an otherwise hopeless war.

%featured%I have Lupus and Terminal Breast Cancer. It is getting more difficult for morphine to control the pain I deal with constantly. Though right now I can still find activity and enjoyment in my life, I know my near future will not be promising.%featured% I want to be able to encorporate compassionate euthanasia into my care plan as I know my body well and I know it will fight death to the point of making for me a long and drawn-out tortuous one.

No one should have a say in what a person wants for themselves.I would never want to watch a loved one suffer when theres no need to.For everyone against it,your not the one going through it,so i think its a selfish,ignorant choice thats being pushed on people.

We should be allowed to die with dignity! This should be decided by the person, talked over with family & at a family doctor meeting notarized! That gives time for the person to reconsider.
Handle it like a DNR where there is a recorded personalized number on the certificate signed by an authorized person.

I detest the word euthanasia. I want to have choice about my dying, but don’t feel dying needs to be medical iced. Just give me the tools and the freedom to use them. Ideally with loved ones at my side.

George Konok
I am a retired surgeon and I saw a lot of suffering during my professional life.I was one of the first ones in my province who advocated the formal organization of palliative care recognizing its value for terminally ill patients.I also learned the significant limitations in our ability to alleviate unnecessary suffering.To me dying with dignity and without suffering is the final phase in our life and,at least in my opinion,the medical profession cannot divest itself of the responsibility.For me when and how to die is a personal decision.It is not a refusal to get the best possible palliative care,it is a means of avoiding unnecessary pain and suffering.I am not a religious person so faith will not help me in difficult times.In fact the mere knowledge that physician assisted suicide was available when and if the time came would make persisting with palliative more acceptable to me and many others.
I am sure there could be enough safeguards to protect the disabled,but nowhere in the world,where the process was legalized has it led to the wholesale murder of the innocent and disenfranchised.
Yes,we need more effective and better organized palliative care,but for me at least,nothing could be better than dying peacefully at home surrounded by my family.

Soon seniors will outnumber the ppl aged under 14 at a ratio of 4:1 according to pop stats that are coming if not already here. This is due to many baby boomers and their offspring. Clearly our health care system did not project for this influx of seniors so quickly and has no clue what to do with them. There are no care spaces for them and very quickly the longer human lifespan, which seemed so important as a projection of how long humans exist compared to the 19th century has now lost focus. It’s all about sustainability. Physicians are being encouraged to promote care goals for seniors that make them comfortable but do not push life saving measures. Sadly, there is a general belief that once you hit a certain age bracket why would you want to be here? Survival of the fittest, reigns supreme.
The truth is it is possible and valuable to have your loved ones as seniors have full happy productive lives well up into their ’90’s. They should not be tossed to the side like refuse. Nor should they be made to feel like they are a burden to society. Many elderly are feeling rejected and depressed because they do feel pushed out.
Fact: you get one life, that’s it! You should be able to keep it until you expire. If a person is suffering from depression because of social neglect there should be programs that support the reconnecting of these ppl with supports in their age groups, not supports to make them more depressed so they feel like they would be better off dead.
It is very hard to decide for another person.

You see the law already gives the right for physician to actually end your life. Okay I said it in a pretty harsh way but your physician is aloud without your consent neither of your families and have “do not resuscitate”. Which in my belief is one of the reason why they wont allow euthanasia or assisted-suicide. As per the other reason was that people who do ask for it will either take advantage of it in the wrong way meaning that they will either ask for it because they are in a vulnerable state of mind or just take it too soon without hearing other options that they have. Again we can contradict that with Netherlands, where they have legalized euthanasia with strict rules to fallow and it seems to work pretty well there. Many articles have been publish contradicting the law on how they allowed passive euthanasia without even them noticing. Do not get me wrong in there eyes it was simply because it was a natural way of dying, where as my opinion having a machine be the will of my life not a natural way.

After reading above article, a main item stood out for me:
What is the goal of passing any such measures?
If the goal is to empower Canadians with making their own end of life lifestyle choices; then there appear to be too many restrictions posed on the timing of death because a capable not clinicly-depressed individual may decide to die with dignity on learning of their terminal illness rather than waiting until they experience the ravages of their illness. This may be a lengthy time if the terminal illness is progressing at varying levels and rates.
Each individual defines their “dignity” based in their life and cultures. Therefore when she/he decides to go with the end of life divinity it may not be for pain or becoming disabled but for taking their life back in their own hands for the last time and to have they personal say in their final hours, days, months.
From above discussions it’s clear that this is a complex decision for those who are ill, families, and physicians.
I agree with physicians and care providers having the free and clear choice in participation. Are We. truly facilitating the free and clear choice to The community member who is ill? A decision does not turn into reality unless the choice is real I.e. free and clear of strings attached that may hinder our rights as basic human beings.
I Fully agree with an infrastructure being in place but one that also takes into account and offers some flexibility for cultural choices in ending life with dignity.
Perhaps most important is to realize the enormous courage that it takes for first the community member and then all participants to honour someone’s wishes. Even when the laws pass, I can’t see people rushing to it but just having the choice to be able to can bring peace to many.

After reading all of the above comments I realize two things. First, everyone has a right to live and die in the way they see fit, after all we live in a Country which allows us all the freedom of choice. We, not others should be making our decisions to die in a matter of our choosing.
Second, every comment written by the religious right is filled with gobbledy gook, typos and incoherent ramblings. They are so focused on their “god speak” they never bother to read or respond intelligently.
So really, who should be deciding something for us in our final days or weeks? Us or those who never really listen or care and just have an agenda.
Thank you all for your thoughtful insights and compassion. After all in the end we are all alone, unless our families can be there when we decide to end it without worrying they will end up in jail.

I feel that Doctors who are ethically obliged to not participate or refer patients to willing Doctors should be Grandfathered out of participation and allowed to continue practicing medicine. However anyone taking their oath to practice medicine from this day forward must agree to participate fully.

God gave us life! it is a gift and you choose to take it away. Instead of suicide, because it is suicide, you should find comfort in the Lord. Offer you sufferings, your pains to Jesus and he will give you the graces to carry your cross or take away your illness. A deep faith in the Lord will help your suffering. Suicide is taking away the gift; the life that God gave us. Our life on earth is only temporary, our true life is eternity in heaven, enjoying God’s true glory, not that one on earth. But that does not mean to take away our life because we are suffering. It is the Lord’s decision when to take your soul, your life, not ours as he is the one who decided that we would be created.

Please don’t vote for Euthanasia, or physician assisted death. It is not right. It goes against our purpose of being. Please save your souls because what you are doing is only separating yourselves from God. He is our only salvation.

I pray that your souls go to heaven. Pray to our Mother Mary the same.

I lost my father several years ago also to a brain tumor. He was a physician and was well aware of his diagnosis and prognosis. If euthanasia or PAD (physician assisted death) had been options, he would have certainly exercised them. He never wanted to get to a state where he was in palliative care at the very hospital he practiced at with his colleagues becoming his caregivers. It was so difficult on the family when he became mentally incapacitated. What was even more alarming was that the health system had challenges providing the care that he needed. Given that he would have preferred to control his own death and have his dignity intact and given the limited resources for our Canadian universal healthcare system, allowing euthanasia would be far more dignified than having families beg for homecare and other resources that the health system simply cannot provide. The undue stress on patients and families including the terrible memories of their loved ones last few weeks or months that can take years to overcome are unjust. I urge the government to allow patients to die with dignity and to those who oppose, I would challenge you to look at how we view the death of animals who we currently treat with more respect at end of life than humans. It’s considered to be inhumane to allow animals to suffer unnecessarily but it’s mandatory for humans? Anyone who has ever witnessed their loved ones suffering a long, painful and humiliating death would be supportive of this movement.

It’s just obscene, the people who vote against such a thing. Those people should SUFFER like WE do as we writhe in extreme PAIN, awaiting for the end. Some narcotics help, but not really. Besides I don’t enjoy being all doped up to a point where I can barely think straight. Let ME live how “I” want, and when it gets to be too much, allow ME to decide that it’s time to GO. If you bunch of cruel, inhumane people prefer to have me SUFFER, when I wish for you the same or worse suffering when it’s your turn, and hopefully it will be horrific cancer as well. Getting your demise in order… the insurances to ensure thing go how you want, plus it’s a TON easier when they know you’ll be gone when YOU give the word, so there’s no mistaking the Will is looked after right away, no arguments or resentments, etc.
I’m sure Euthanasia will be available for YOU… so why not allow US to have it NOW also. Enough people have suffered over this crazy Christian ideal, that we must hang on til the END. So stupid. If I’m to be struck down because I ask for mercy… then fine.

Just go simple with this make it a “job” or the person who does the “deed” becuase it seems from my less than a hour skimming through topics, most doctor or physicians won’t want to do it.
Have said person take psychological tests regularly to determine if they are still fit to do it but not something so strict that the requirements are at such a level that it is impossible for anyone to do but just some who would refrain from gossiping, openly expressing joy or enjoyment as to show respect and dignity for the person who requested “assistance”.

With this maybe the only part physicians are included in the act is to provide the “method” as to uphold the law as it is currently stated.

Only reason I give this idea is because it is just to provide a easier or different choice on their part. As well with the direction that this has reached if not now, most likely later or sooner then expected.

As a nurse, I have witnessed many people dying. Unfortunately, most Canadians have seen few people die and its still about the length versus the quality of life. Too many Canadians are dying in emergency rooms and in hospitals. Palliative care and dying – most want to die at home but they are mislead into a false hope and once they are sick they are controlled. It really upsets nurses to see dying patients treated with chemotherapy and intervention to prolong the inevitable. Most Doctors are very poor at discussing death with their patients until they have been “treated” “to [the point of] nausea and repulsion. Doctors are in a conflict of interest – they make money on procedures and treatment. They also have poor training when it comes to death and dying. I have seen numerous physicians discuss end of life care with relatives and leave out the patient !! This is not informed consent and families do not represent the individual. We make assumptions about others based on our life – this is wrong. ASK the patient directly, ensure every patient has a directive on file. Respect their wishes. In addition to years of experience, when my own father was dying at home, receiving palliative care by home care nurses, I had to continually safeguard my father against his physician who wanted to continue needless interventions and CT scans. He was dying – he knew he was. He died peacefully at home with his family by his side.

This is very worrisome for elderly persons with incurable medical conditions. Doctors will be the ones deciding who should live or die, without patients consent . It is a real slippery slop that we are approaching, or for that matter ,are all ready here in Quebec. I am an elderly with medical conditions that are untreatable and will cause havoc for me along the way. I am frightened to even go into a hospital anymore as some medical staff may see my life as not dignified enough , and euthanasia me.
You would think that my country would offer me the best of care and respect, in my elderly years for having contributed to the society that I live in ,and have never broken any laws. They have abolished the death sentence for criminals who have killed other people but they think nothing of taking my life just because I am old. I do not believe in capital punishment either, as no one but God has the right to take a life, if you do then it is called murder.

As a young divorced mother I worked long and hard to raise my children to respect life and the law and to have compassion for the sick and disabled. What are teaching them? My life now, as an elderly person, has turned into fear and disgust at this “throw away generation”.
All the expense that you say the elderly cost, has been a windfall for the pharmacies . The cost to your hospitals is totally due to miss management of your resources and lack of records management. I think you should look into the cost that pharmacies are over pricing you and the elderly for medications, and leave us live out our life in peace, with some care from the doctors that have sworn “to do no harm”
I would like to discus this with someone .

Legalizing euthanasia could be misinterpreted by some.
My father was recently passively euthanised without family’s consent in Toronto mainly because this is legal but I’m not sure its legal when its involuntarily done(?).
(Since my father was unable to talk, the doctors withheld artificial hydration.) I now learn that my father had choices and he may have survived if doctors had discussed other options with family first.
Latest traditional method used by hospitals – 3 days of palliative sedation thereafter patient is no more on the fourth day. age and gender bias also appears to be an issue. doctors do not disclose to families that thier beloved family member would be euthanised mainly because passive euthanasia is “Legal”.
J.s.
Toronto

i don’t believe it and for one reason the private hospital have been killing off old people for years. My mom is heavily medicated all the time and she had a stroke a few years back and because she couldn’t walk or talk at all since i was seeing her so never the end they were giving her morphine every hour and 1 nurse came to me and told me that my own father didn’t have to go that way. I had feeling for sometime they were doing things and plus they would tell me to call them first so they can get her ready..but it was to cover up so i would not know. I came there and they had stopped giving her water and feeling her . She could not talk and ask what she needed cause they had her on meds to keep her from asking anything. So she lied in a bed day in and day out with a tv on while the other nurse were helping the other people. It has been every time i showed up she was not moving but ly there So as these people work there and no one is watching these nurse on what they are doing who is helping these older people. I saw a yellow bruise on my mom right side of her head and when i ask what happen they said she rolled over. she can’t roll or walk or grab. they have been abusing my mom an now she gone all i have is the last two day before she passed and when i look at the picture it like she dead,,as he skin is sucked to her bones..these private hosptial need to be watched

People with Disabilities are a protected group under the Charter, and under the UN Convention on the Rights of Persons with Disabilities. Including “disability” in this legislation is like including ethnicity or gender. The reason people with disabilities have explicitly stated rights that are equal but specific to their circumstances, is because of historical abuse, discrimination and exclusion from society. That is what also makes people with disabilities vulnerable. Not so much their conditions. The “dis” part of disability are the external barriers and prejudices that still prevent full inclusion in society. The reason why people may feel “undignified” living with a disability is because of prejudices projected by society, and systemically engrained in it, that they then internalize…we systemically, as a culture, devalue lives where a person’s capacity is not “normal” in some way…and yet, no one really fits a perfect able bodied norm all of their lives. With appropriate supports no one should feel like a burden if they become disabled. Everyone’s life has intrinsic human value. What makes this law extra dangerous is not limiting it to the very end of life (and even that’s an unknown) and not qualifying what “suffering” is and what’s causing it. If it’s a neglected social need, a gap in necessary care, or social prejudice… Those things are making a person feel suicidal and they should have access and be shown concern with suicide prevention measures like anyone else. But it is too easy, based on prejudice, to assume that a disabled person doesn’t have the same rights to suicide prevention regardless of cause.

Another thing is … There are terrible examples in history of how eugenics and euthanasia were promoted to make the public feel comfortable with it , and remove culpability from doctors, before going down a horrific slippery slope. Don’t assume it could never happen again.

This is about disability…because the people who gave us ramps on buses, automatic doors, employment and education access laws, and independent living opportunities were people with often severe disabilities who LIVED their lives with dignity, and still do, to make that happen. So that you can get on a bus or into a building whether you have a wheelchair, a broken leg, or a baby stroller. I imagine none of those changes happened without a fair bit of “suffering”, that people felt it necessary to endure. And yet, discrimination from employment, public access, social events, and necessary services and care, is still pervasive. There’s still work to be done. It’s a shame that this “choice” became law before those barriers were addressed, because to feel backed into a corner without support and necessary accommodations is not actually “choice”.

This document is provided under the terms of a CreativeCommons Attribution Non-commercial Share Alike license. The terms of the license are available at: http://creativecommons.org/licenses/by-nc-sa/3.0/. Attributions are to be made to HealthyDebate.ca, a project under the direction of Dr. Andreas Laupacis, at the Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital.